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L to R : Dr Landin, Omondi, Franklin , Philip Barasa, Oscar Kituyi, Dr Pedro Cavadas

 

Pedro Cavadas Foundation continue its activities started last December in Nakuru, Kenya. During our visit we met four children from Bungoma (Western Province) for surgical screening. Three of them Oscar Kituyi, Philip Barasa and Omondi had suffered mutilation of their penis.

The amputation of their penis was due to a belief in which the penis of a virgin boy is used to prepare a potion that can heal HIV/AIDS. This is not a ritual nor a tradition of Kenyan tribes. This is a crime, and two people have been arrested although not judged yet.

Philip Barasa and Oscar Kituyi have travelled from Kenya to Valencia (Spain), sponsores by Kenyan Airways and KLM Royal Dutch Airlines.

Philip (12 years) was attacked by a man who was not known to him. He was travelling 35 km. to meet his mother, who was sick and hospitalised, when someone offered him some food. After a while he fell asleep, but a big pain woke him up. He was half-buried in a sugarcane plantation and it was dark night. He crawled to a nearby village, from where he was sent to a hospital.

Oscar (14 years) penis and scrotum were chopped off a month later. Someone he didn´t know offered him work and money. He took Oscar to his house where a cup of tea was offered. After a while he felt asleep. Afterwards he woke up in big pain, and two men where pulling his trousers and chopping off his penis. He fought back, until he lost conciousness. When he woke up he was bleeding, and dogs where licking his wounds. During the fight he had his left ear cut off and the left radial nerve swored.

Omondi (6 years) has suffered the same trauma. He will be to Spain in the next months.

To know more about these children, click here.

After arriving to Valencia, Philip and Oscar came to Centro de Recuperación y Rehabilitación de Levante, where Dr. Pedro C. Cavadas and the team of Hand Surgery & Microsurgery would perform the surgeries.

After a complete examination protocol, we decided to schedule surgeries as follows:

1st day:

1.Left auricular reconstructin of Oscar, as stated by Nagatta´s technique. We took costal cartilage, molded it and introduced it in the temporal area. In a few months we will be able to set it in the correct position.

2. Functional repair with tendon transfers for radial nerve palsy.

 

Click on images to enlarge them

Cartilage framework	Cartilage insertion
Dr. Cavadas during cartilage framework design	Early result

 

2nd day:

Penile reconstruction (total phalloplasty) of Oscar with free sensate osteocutaneous radial forearm flap.

Surgery took seven hours. First of all revision of amputated penis was performed, preparing the healthy corpus cavernosum and urethra. Testicles had been amputated. Nerves of penis were dissected and prepared for reconstruction.

Afterwards a free sensate osteocutaneous radial forearm flap was elevated. Skin, fat, subcutaneous tissue with arteries and veins, nerves and radial bone were dissected and prepared for reconstruction. A new penis was built with the flap, leaving a strip of healthy skin to avoid lymphedema in the hand. Finally the forearm was covered with skin grafts.

In the groin a vascular by-pass was prepared for vessel anastomosis. The radial bone was inserted in the corpus cavernosum, and the vascular and nerve repair was performed.

Oscar will use a urinary catheter for two weeks, until wounds are healed. Sensation of penis will recover in the next 4-6 months. The new penis is mobile, allowing to put it by the abdomen or the tight, grabbing it with the hand for sexual intercourse.

 

Click on images to enlarge them

Phalloplasty	Free sensate osteocutaneos radial forearm flap
Skin grafting of donor area	Final result

 

3rd day:

Philip´s total phalloplasty was performed with the same procedure. In the same time urinary fistula was repaired.

Click on images to enlarge them

Repair of urinary fistula	Osseous part of the flap
Repair of corpus cavernosum and radial bone	Free sensate osteocutaneous radial forearm flap

Surgical Team

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